Lower respiratory tract pathogens and their antimicrobial susceptibility pattern in a medical hospital of central Nepal

Abstract

Background: Lower respiratory tract infection (LRTI) is one of the major causes of morbidity and mortality in young children and elderly people. It is among top ten diseases of Nepal and accounts for deaths of 2.6 million people per year. Objectives: To identify causative agents of lower respiratory tract infection and to determine their susceptibility to antimicrobial agents, with special interest to multidrug resistance (MDR). Materials and Methods: The study was carried out in 240 sputum specimens received in the Microbiology Laboratory of Chitwan Medical College Teaching Hospital within a period of 6 months (April- September, 2010). Results: Total positive result was observed in 73 specimens (30.42%). Infection rate in males (58%) was higher than in females (42%). LRTI was mostly seen in age group of 61-75 years. Altogether 9 different species of bacteria were identified, majority of which were Gram-negative bacteria (73%). On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum sensitivity to gentamicin (100%) while Gram-negative bacteria showed variable response towards different antimicrobials. Prevalence of MDR was higher in Enterobacter spp (100%) followed by Escherichia coli (90%). Conclusion: Varieties of pathogens are responsible for LRTI and antimicrobial resistance has become significant public health problem in central Nepal.